Symptoms of toxoplasmosis in humans, the route of transmissionand diagnostics

Update: October 2018

Toxoplasmosis is a parasitic disease that occurs in response.
to infect the body with protozoa coccidia order – Toxoplasma
gondii. The main sources of infection are sick animals, in
mostly – representatives of the cat family.

It is a disease caused by a “sensible” parasite.

Toxoplasma gondii has long attracted the attention of scientists as
unusual parasite precisely because of its properties. To from the body
the rodent is ingested by the cat – its main carrier – it is
in some strange way inspires a rodent desire to smell feline
urine AT результате такая мышь становится легкой добычей, и
Toxoplasma is ingested by a cat. If the parasite gets to
to man, this is not always manifested by any symptoms,
talking about the disease: in most cases, the pathology proceeds
asymptomatic, imperceptibly affecting only the personality of the person. Some
scientists believe that one such change is love for
cats.

If a large amount of Toxoplasma is ingested,
or at the time of infection the immune system was weakened, toxoplasmosis
develops acutely. AT этом случае он characterized by развитием
inflammatory changes in the eyes, muscular system, central
нервной системы и других внутренних organs. Most dangerous
Toxoplasmosis in a pregnant woman: parasite causes
severe violations of internal organs, especially the brain
fetus.

About toxoplasma

Toxoplasma gondii was discovered only in 1908. Her
found in the internal organs in the form of an arched parasite
forms, therefore, called “toxoplasma”, which means “arc”. A little bit
later scientists found that this microorganism is capable of causing
deadly disease, especially in infants, to
which he gets through the placenta.

Because Toxoplasma is a parasite, not a bacterium or
a virus, it “lives life”, going through certain stages
development. Her жизненный цикл условно делится на 2 части:

  1. When the parasite is asexual. AT этой форме он может
    be in any animal (except cold-blooded), bird or
    man ATсе они называются промежуточными хозяевами. Some
    of which it causes disease, and in some it causes a change
    behavior. So, an infected mouse gets pleasure from the smell
    cat urine, which leads her to cat’s paws. And birds Nene, almost
    half of the population that is infected with toxoplasma is affected
    the parasite begins to behave extremely reckless and change its
    manner of flight, which leads to their injuries and death.
  2. When he gets the floor. This is only possible in the body.
    cats, where the parasite and seeks.

Getting to the intermediate host, toxoplasma penetrates first
in his cells, then damage them and end up in space
between cells enclosed in a protective sheath. It is called
parasitophore (i.e. parasitic) vacuoles (i.e.
bubbles). They can merge into large bubbles – cysts, and
the process of cystic formation can occur in almost all internal
organs:

  • in the lungs;
  • in the kidneys;
  • in the liver;
  • in the brain;
  • in muscle tissue (including the heart);
  • In eyes.

Until these cysts are mechanically damaged, the parasites in
they multiply slowly and out for 2 years or more
don’t stand out. The cysts shell is sufficient protection against
immune cells, so the body does not begin to fight parasites.
If at this time a person starts taking antibiotics, part
(greater or lesser) toxoplasma may die.

Паразиты хоть и медленно,  но постоянно размножаются. When
there are too many of them, they damage the membrane of the cysts and
go outside. Some of them are destroyed by the immune system, some
again enters the cells, where they form new vacuoles.

When этот цикл происходит в организме грызунов или птиц, то,
to form female or male toxoplasma, such an animal
must eat cat. When паразит «обосновался» в организме
man, this is a dead end for him.

With попадании в кишечник кошки, токсоплазмы начинают в нем
to multiply, but not sexually. This is how oocysts form.
peculiar “eggs” enclosed in a dense shell. Such
oocysts are excreted in the environment where feces are stored
for a long time, infecting other people. Duration
maintain the original properties of toxoplasma in cysts up to 2
years old. AT данный период попадание цисты в организм человека способно
cause the development of a complete pathological process.

Russia is considered an endemic area for toxoplasmosis.
The number of carriers of infection among all residents of the country is
more than 30%, among the inhabitants of the world – 65%.

Infection mechanism

The source of infection is infected animals. The final owner is
cats ATыделение токсоплазм из организма хозяина происходит с
feces, urine, milk and saliva. Man is intermediate
хозяином pathogen.

Ways of transmission: Токсоплазмоз симптомы

  • пищевой – употребление в пищу продуктов,
    inseminated with cysts with the pathogen. Most common infection
    occurs when using insufficiently heat treated
    lamb meat, pigs, cows, deer. You can also become infected if
    do not wash your hands after cleaning the cat litter;
  • при пересадке органов, в том числе – при
    blood transfusion from an infected person;
  • контактный – попадание биологической жидкости
    (most often – cat urine or feces) with a pathogen on
    damaged skin or mucous membranes;
  • вертикальный – от матери к ребенку;
  • трансмиссивный – при укусах насекомых – еще не
    proved, but its probability is discussed.

Symptoms of congenital toxoplasmosis

With внутриутробном инфицировании происходит трансплацентарная
transmission of the pathogen from an infected mother to a child. ATнедрение
Toxoplasma in the unborn child can occur on any
gestational age. AT данном случае формируется врожденный
toxoplasmosis, the symptoms of which have characteristic features in
depending on the period of infection. Read more about toxoplasmosis with
pregnancy in our article.

Up to 2 weeks Death of the embryo and development of blastopathy
2 week – 2 month ATыкидыш или формирование множественных пороков development.
2-6 month ATнутриутробное воспаление с последующим склерозированием
body.
6-7 month ATнутриутробное воспаление и задержка развития внутренних
organs. Postpartum chronic course of the disease.
7-8 months Subacute form of flow at birth. Organ damage
central nervous system, eyes. Increased hydrocephalus.

One of the most common variants of the congenital form
disease is early intrauterine toxoplasmosis, with
which is a violation of the processes of organogenesis with the formation
defects incompatible with life. Such a pregnancy is
absolutely hopeless and in 90% of cases ends
spontaneous miscarriage.

Significantly worsens prognosis of congenital survival
toxoplasmosis in children, the symptoms of which appear either
immediately after birth, or after incubation
period of infection. For newborns with intrauterine infection
Toxoplasma characterized:

  • marked inflammation of the cornea of ​​the eye, cerebral
    fabrics
  • multiple abnormalities of internal organs with
    the subsequent replacement of the foci of inflammation of the scar connective
    cloth
  • with infection in the second trimester of pregnancy manifestations
    congenital toxoplasmosis characterized by multiorgan
    inflammatory changes with severe physical and physical delay
    mental development.
  • in the case when the infection occurred in the later stages
    pregnancy, the acute period of the disease accounts for 2-5 days
    life and is characterized by an increase in brain manifestations and defeat
    eye. ATпоследствии к данным симптомам присоединяются лихорадка и
    multiple organ failure.

The clinic of congenital toxoplasmosis depends on the nature and extent of
поражения внутренних organs. Multiple violations
characterized by severe disorders of brain activity in
lack of reflexes, respiratory failure, reduced muscle tone,
lack of reaction of pupils to light. Most common
congenital anomalies of the nervous system in toxoplasmosis
are microencephaly, hydrocephalus, or complete absence of the brain.
Along with this, the formation of cerebral hernias with
increased intracranial pressure. Peripheral nervous system
rarely affected.

With позднем внутриутробном заражении, когда все органы плода уже
formed, congenital toxoplasmosis will manifest signs
тяжелого воспаления мозговой fabrics – менингоэнцефалит. For him
characterized by:

  • Change of periods of anxiety and lethargy
  • Painful reactions to movement of the limbs, turns
    heads
  • Bad sucking reflex
  • Low motor activity
  • Paralysis or paresis
  • Weight loss

The disease is accompanied by common manifestations in the form of an increase
temperature, paleness of the skin, vomiting. For severe forms
characterized by convulsions, anemia increase, lymph node enlargement,
liver, spleen.

Withблизительно в 5-7% случаев у новорожденных отмечается
subclinical toxoplasmosis, whose symptoms may
be absent or have an erased character. For this option
currents are characterized by an increase in hydrocephalus and delay
psycho-emotional development of the child.

In children with congenital toxoplasmosis, intellectual
sphere. They have periodically marked motor attacks.
excitement, hallucinations, depressed mood.

Withобретенный токсоплазмоз

The most common form of the disease is
acquired toxoplasmosis, whose symptoms are characterized
a gradual increase in complaints and depend on the place of implementation
pathogen. The manifestations of acquired toxoplasmosis depend on
affected organ and type of disease. More common
chronic course from asymptomatic to severe inflammatory
изменений с тяжелым нарушением функций внутренних organs.

The incubation period of acquired toxoplasmosis is
5-23 days (on average 12-14 days). At the end of this period,
patient with acute toxoplasmosis arise and grow sharply such
disease manifestations like:

  • ATялость, утомляемость;
  • Fever (above 38 degrees Celsius);
  • Headache;
  • Aches in the joints;
  • Increased regional lymph nodes (especially cervical and
    occipital);
  • Periodic abdominal pain, especially in the right
    hypochondria;
  • Eye damage;
  • Irritability;
  • If the heart is affected, there is a decrease in arterial
    pressure and increased heart rate;
  • Enlarged liver, spleen;
  • Pneumonia, encephalitis.

The acute course is not always noticeable – only in 0.3% of cases, and
характерно для людей, чья иммунная система ослаблена (при ATИЧ
infections, tuberculosis, cancer, after radiation or chemotherapy). It
Lasts from several days to several months; characterized by
lightning fast with a rapid increase in intoxication and
воспалительных изменений пораженного body. Forecast при остром
the course of toxoplasmosis is unfavorable, the disease is often
is fatal.

With нормальной работе иммунной системы приобретенный
Toxoplasmosis occurs in subclinical form, and after
выздоровления вырабатывается стойкий пожизненный immunity.

Most often, toxoplasmosis develops according to this scenario:
symptoms suggestive of infection are not noticeable. Disease right away
goes into a chronic stage, which they say:

  • Headache, weakness, deterioration of performance
  • Memory impairment
  • Decreased appetite, sleep disorders
  • Adynamia
  • Long subfebrile temperature, not stopable
    nonsteroidal anti-inflammatory drugs
  • Constant coughing, sore throat
  • Chronic runny nose
  • Frequent colds
  • Joint pain
  • Behavior change: propensity for risky
    deeds, the instinct of self-preservation is dulled, while the reactions are
    slow down
  • Periodic unexplained feelings of anxiety
  • In women, an increase in sociability, a tendency toward overt
    conversations
  • In men, a decrease in cognitive activity
  • Formation of phobias, mental disorders.

There is also an assumption that there is a relationship between
toxoplasmosis and schizophrenia:

  • higher titers were found in the blood of such patients
    antibodies to this parasite;
  • damage to astrocyte brain cells in schizophrenia and
    toxoplasmosis – identical;
  • some drugs “for schizophrenia” when injected into a test tube with
    Toxoplasma can stop its growth.

ATысказывается также предположение, что симптомом появления
Toxoplasma in the body can be considered as having appeared or increased
love for cats ATполне авторитетные ученые даже высказывают
the opinion that there is a connection between the carrier of parasites and the global
feline fascination.

AT дополнение к перечисленным, характерным для токсоплазмоза
the symptom in women is a violation of the menstrual cycle,
hormonal disorders. In pregnant women, the habitual
miscarriage. If the fetus is infected, it can
develop:

  • hydrocephalus;
  • пропитывание fabrics мозга солями кальция;
  • inflammation of the eye structures (chorioretinitis);
  • intrauterine death.

In addition, concomitant manifestations of the disease are
changes in the affected organ. For organ damage
cardiovascular system is characterized by the appearance of increased
palpitations, pain in the heart, arrhythmias, hypotension.

Поражение токсоплазмами пищеварительной системы characterized by
loss of appetite, pain along the intestines, bloating
abdomen, increased gas formation. Endocrine disorders
manifested violation of the menstrual cycle in women and impotence
in men.

If a person is depressed immunity, however, he overcame
the acute stage of toxoplasmosis and did not die, the disease turns into
chronic form. AT этом случае в большинстве случаев развивается
энцефалит, который characterized by такими симптомами:

  • headache;
  • nausea;
  • temperature increase;
  • convulsions;
  • loss of symmetry of the face;
  • impaired movement or sensitivity in the limbs.

Toxoplasma encephalitis often becomes fatal to
person with immunodeficiency.

Diagnostics

With осложненном анамнезе и появлении симптомов, сходных с
signs of toxoplasmosis in humans
conduct a series of specific studies to confirm the presence of
Toxoplasma in the biological fluids of the patient.

With the help of parasitological methods are analyzed
material obtained after blood sampling, liquor and during
биопсии какого-либо body. With микроскопии мазка на наличие
toxoplasmosis indicate multiple cysts in sight
microscope.

Informative and highly sensitive method of determining
Toxoplasma circulating in the blood is PCR. ATыявление
specific immune complexes secreted in response to the introduction of
pathogen can also give comprehensive information about the nature of
process and the state of the patient’s immune system.

type of analysis the patient was not infected if infection occurred more than six months ago if infection has recently occurred
IgM blood test +    и при повторном анализе увеличение титра
IgM in 2-3 weeks
IgG blood test +   или титр IgG с высокой авидностью –    титр Low avidity IgG or titer growth
IgG after 2-3 weeks
PCR blood test� +
ELISA analysis (ELISA) +

In addition to direct diagnosis, the doctor prescribes
examination of cardiovascular, musculoskeletal,
digestive systems. This ultrasound of the organs of the abdomen, heart, soft
tissues, eyes, x-rays of the lungs. The purpose of such a diagnosis is to evaluate
degree and nature of lesions caused by toxoplasma.

Treatment

In people with immunocompromised immunity the body itself suppresses
acute toxoplasma. Treatment обязательно
held at such categories of persons:

  • pregnant women;
  • newborns;
  • receiving cancer treatment;
  • with autoimmune diseases;
  • when toxoplasmosis is detected after a blood transfusion or
    organ transplantation;
  • HIV-infected people who have a CD4 + level of less than 200 cells / ml,
    or at the stage of AIDS.

In the acute stage of the disease, antimalarial and
antibacterial drugs; HIV-infected – their
combination:

  • �Mepron;
  • �Biseptol;
  • �”Aminohinol”;
  • �Clindamycin;
  • �”Metatsiklin”;
  • �”Spiramycin”;
  • �”Rovamycin”;
  • �Daraprim;
  • �”Arguedin”.

During pregnancy, some of these drugs also
allowed to use.

At the chronic stage in persons with the absence of antibodies to
HIV infections are also prescribed
immunity.

Forecast

Acquired toxoplasmosis with adequate treatment and normal
the immune system tends to gradually regress.
Recovery occurs in 1-4 months. After illness function
affected organs may not fully recover as
on the place of the inflammatory foci formed zones of scarring. AT
small cicatricial deformity remains in the vitreous
retina.

Recurrence of damage to the eyes and the nervous system has
50% probability. It requires long-term follow-up and
prevention.

AT целом прогноз при приобретенном токсоплазмозе остается
favorable, ensuring the recovery of 95% of patients. With
congenital toxoplasmosis survival rate of newborns
is less than 40%.

Автор: Коробов Никита Александрович врач-анестезиолог

Like this post? Please share to your friends:
Leave a Reply

;-) :| :x :twisted: :smile: :shock: :sad: :roll: :razz: :oops: :o :mrgreen: :lol: :idea: :grin: :evil: :cry: :cool: :arrow: :???: :?: :!: